In a recent online publication “Literature Review: Medication Safety in Australia. Australian Commission on Safety and Quality in Health Care,” Roughhead et al. provide data on adverse events and medication errors due to negligence of medical personnel [10]. Indeed, when one looks at the data presented, it is surprising that the magnitude of medical negligence claims is not proportional to these statistics. For example, interspersed in the “Hospital Medication Safety” section, medication error data includes medication administration errors (5-10%), intravenous medication errors (70%), prevariously inducing prescribing errors (2.5%), clinical prescribing errors (0.2%), software-attributable prescribing errors (0.6%), errors in procedural prescribing (5%), leave errors (12-80%) and medication delay errors after the Transition (20%) Negligence is currently the largest and most widespread crime, which is rapidly becoming a basis of liability in almost all human endeavors. In recent decades, neglect has evolved from coverage primarily for bodily injury and property damage to prosecution for economic loss and psychiatric illness. It has been difficult to develop predictable and consistent principles to achieve equity and minimize negative impacts on the community as a whole. However, there are some common procedures for determining medical negligence: What standards are required of medical professionals and specialists with respect to pre-trial disclosure? Originally, the obsolete Bolam test was widely used. The Bolam test, as excerpted from Bolam v.
Friern Barnet Hospital Management Committee (1957) [23], states that a professional body determines the standard of qualification and diligence, that no liability for negligence is extended if peer-to-peer proceedings are not common, and that petty procedural risks do not need to be explained. In terms of disclosing minimal risks to patients, the Bolan test was supplanted by the Roger v-Whitaker principle, in a case in which a specialist was held responsible for failing to disclose sympathetic ophthalmia as a possible (albeit small) risk for eye surgery [24]. The Roger v Whitaker Principle states that all risks, including very small risks, must be communicated to a patient before agreeing to a procedure. Negligence is the most common crime for all health professionals. Evil is death; or physical and/or pathological and/or psychiatric injuries caused by a nurse`s negligence towards the patient. The damage is caused by an adverse event – an injury caused by medical management that prolongs hospitalization and/or hinders discharge or death [10]. A likely sequence of events begins with a duty of care; resulting in poor diligence or lack of due diligence known as negligence; resulting in an adverse event resulting in damage. Compensation is compensation granted to the patient by court decisions. Negligence results in compensation for economic or immaterial losses and sometimes special damages. For decades, the common law has regulated negligence. Following Justice Ipp`s review in 2002, each Australian state and territory enacted parallel civil liability legislation with specific medico-legal negligence clauses. From the following two cases before the CLA, two medico-legal principles can be extracted in relation to higher-level and/or unrelated clinical conditions.
In Baker v. Willoughby (1970), the injury to the plaintiff`s first leg was inflicted by the first defendant. Later, a gunshot wound to the same leg, inflicted by a bank robber, led to the amputation of that leg. The Court found that the latter event did not reduce the first defendant`s liability for the applicant`s leg injury [35]. This means that legal liability for a breach due to the negligence of a clinician is not exonerated by a second similar breach due to a subsequent event. In Jobling v. Associated Dairies (1982), it was stated that if a plaintiff suffers from a debilitating illness that overwhelms an initial injury due to the negligence of the defendant, this may reduce the defendant`s liability [36]. It is important for a nurse to act legally, as the illegal activities of nurses jeopardize patients and nursing careers.
The constituent elements of legal or illegal nursing activities before the courts were explained. Relevant medico-legal issues and statistics on negligence were discussed. Strategies to help nurses minimize illegal acts were discussed. Unlike New Zealand, which has a no-fault medical compensation system, Australian medical professionals continue to operate under common law and negligence laws. Adverse events are high in Australia. However, the number of new applications is declining. The number of negligence claims is disproportionate to the adverse event statistics. Constant review, recognized disclosure, compliance with laws and common law, scrupulous adherence to established professional standards, and exclusion of practices that lead to poor standards of care are essential for the nurse. Medication errors are a potentially catastrophic medical error. Nearly four of the 10 medical malpractice lawsuits claimed that an error in the administration of the drug resulted in the patient`s death. Are allegations of negligence in Australia appropriate? The latest Australian data (excluding Western Australia) from the Australian Institute of Health and Welfare (AIHW) [45] for the years 2012-2013 show that new public sector demands were lower (~950) than in 2008, 2009, 2010 and 2011 (1200-1400).
Claims in the closed public sector were higher (~1500) than in 2008, 2009, 2010 and 2011 (1100-1400). The number of private sector applications remained stable from 2010 to 2012 (3300). The number of private sector closed-end claims increased from 2010 to 2012 (2400) (3800). It is clear that the number of medical negligence claims is disproportionate to the data on medication errors. The best available evidence to date shows that errors in medication administration in hospital care (without time errors) occur in approximately 9% of drug administrations [13]. Ensuring adequate staffing and regular replenishment of health care personnel can prevent harm to the patient [9]. Proper documentation, timely resolution of complaints, and rigorous reporting of incidents can eliminate or distract from liability and/or burden of proof [11]. Academic details reduce errors in prescribing Schedule 8 medications, and duplication of testing and interdisciplinary communication strategies (involving pharmacists) has been shown to be effective in reducing neglect in medication administration [13]. Although these studies are small, these strategies have been shown to be effective in Australia, as mentioned earlier [13,55]. According to the Coverys report, up to 1 million patients fall into U.S.
hospitals each year. While a fall of a patient was the claim in a minority of nursing medical malpractice, 41% of these fall lawsuits concerned the death of the patient. The overall objective of this article is to educate the Australian nursing community on medico-legal issues, laws and important cases related to the clinical practice of nursing and tort negligence. The research presented in this article focuses on explaining, adapting and simplifying the “corpus and subtleties” of Australian tort law for medical negligence, making it relevant and useful to the Australian healthcare community. This paper uses Australian common law generally; and New South Wales legislation (Civil Liability Act 2002 (NSW) or CLA) in particular. First, this article aims to inform and warn Australian nurses about medical legal issues, legislation/enforcement of negligence and common law issues in Australian medical practice. Second, this article aims to determine the current situation in terms of medico-legal negligence damage figures and adverse events (including errors in drug administration). Third, this article brings together and formulates concise but informative evidence-based approaches to exclude or minimize the medico-legal liability of Australian nurses. There are statutes of limitations for asserting claims for patient negligence. After bodily injury due to medico-legal negligence, the injured plaintiff must within 6 years (Victoria, Western Australia and Australian Capital Territory) or take legal action within 3 years (New South Wales, Queensland, South Australia, Tasmania and Northern Territory) from the first knowledge of the offence [7]. That night, the patient vomited several times during the night shift.
The registered nurse who cared for her documented in the patient`s medical record that the patient had expressed a “lump in [her] belly” but that her pain had decreased earlier in the day. As a caregiver, you always carry the burden of your own potential legal liability and that of your employer on your shoulders. The RN was not a named defendant in the application. However, failure to meet the standard of care for this patient resulted in the hospital`s (indirect) vicarious liability. The basics of the tort tort of negligence are explained step by step. Important judgments and the application of legislation in significant cases of medical negligence are discussed.